| Entity Name: | PHYSICIANS HOUSECALL TEAM, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 02 Mar 2015 (10 years ago) |
| Date of dissolution: | 28 Sep 2018 (6 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 28 Sep 2018 (6 years ago) |
| Document Number: | L15000037620 |
| FEI/EIN Number | 47-3290781 |
| Address: | 1225 HAVENDALE BLVD. #338, WINTER HAVEN, FL, 33881 |
| Mail Address: | 1225 HAVENDALE BLVD. #338, WINTER HAVEN, FL, 33881 |
| ZIP code: | 33881 |
| County: | Polk |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1013300912 | 2015-03-17 | 2015-04-16 | 3616 HARDEN BLVD, #311, LAKELAND, FL, 338035938, US | 1225 HAVENDALE BLVD NW, #338, WINTER HAVEN, FL, 338811349, US | |||||||||||||||||||||||||
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| Phone | +1 863-268-2921 |
| Fax | 8632682923 |
Authorized person
| Name | BYRON RENARD DEAN |
| Role | CEO |
| Phone | 4077196673 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | OS9203 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 245345600 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| ROWLAND TAMARA | Agent | 1208 KIMBERLE COURT, AUBURNDALE, FL, 33823 |
| Name | Role | Address |
|---|---|---|
| ROWLAND TAMARA | Manager | 1208 KIMBERLE COURT, AUBURNDALE, FL, 33823 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2018-09-28 | No data | No data |
| LC STMNT CORR | 2015-05-29 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2015-05-29 | 1225 HAVENDALE BLVD. #338, WINTER HAVEN, FL 33881 | No data |
| CHANGE OF MAILING ADDRESS | 2015-05-29 | 1225 HAVENDALE BLVD. #338, WINTER HAVEN, FL 33881 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2017-03-23 |
| ANNUAL REPORT | 2016-04-01 |
| CORLCSTCOR | 2015-05-29 |
| Florida Limited Liability | 2015-03-02 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
